RT Journal Article
SR Electronic
T1 Autoimmune switch from hyperthyroidism to hypothyroidism in Graves’ disease
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e236465
DO 10.1136/bcr-2020-236465
VO 13
IS 11
A1 Preethi Padmanaban
A1 Rohit Jain
YR 2020
UL http://casereports.bmj.com/content/13/11/e236465.abstract
AB We report a case of a 21-year-old young woman who was initially diagnosed with hyperthyroidism secondary to Graves’ disease and spontaneously switched to hypothyroidism in a year. While most autoimmune hypothyroidism is due to Hashimoto’s disease, in her case, we suspect that her hypothyroidism is due to a switch of antibody dominance from thyroid stimulating hormone (TSH) receptor-stimulating antibody (TS Ab) to TSH receptor-blocking antibody (TB Ab). Switching from dominant TS Ab activity to dominant TB Ab activity is a rare phenomenon. Optimal management of this condition is not known. Loss of follow-up and medication non-adherence has made medical management in this young woman of reproductive age further challenging.